Ulcers are painful wounds that are slow to heal and are sometimes recurring. Contrary to popular belief, ulcers can take many forms and can appear in any part of the body.
They can be caused by diseases, infections, and injuries. While some forms of ulcer go away on their own, others can cause serious complications if left untreated. Diabetic Foot Ulcers are common complications for Diabetic Patients. When comparing to conventional methods of treatment, ozone therapy treatment for diabetic foot ulcers is a great alternative.
Types of Ulcer
An ulcer8 can develop either outside (e.g., skin) or inside (e.g., mucous membrane, gut, stomach lining) the body. Regardless of where you find them, these sores can be painful and can take a long time to heal.
Ulcers can form on the surface of your eye. This often causes redness, pain, and the feeling of something being stuck in your eye. Corneal ulcer can be caused by an injury, chemical trauma, or problems in the eyelid.
It can also be a product of the dry-eye syndrome. People who wear contact lenses are more prone to corneal ulcers. This type of ulcer can lead to problems with your vision, including blindness.
Known as canker sores, this type of ulcer develops inside the mouth, making eating, drinking, or talking extra painful.
While there is no definite cause for canker sores, there are several factors that can trigger them. These include mouth injuries, dental braces, or sensitivity to certain toothpastes (especially those that contain sodium lauryl sulfate).
The presence of canker sores can be a sign of a more serious medical condition like HIV/AIDS, celiac disease, or diabetes.
These sores are usually found in the genital area and are generally caused by sexually transmitted viruses like HSV-1 and bacteria like the Treponema pallidum, which causes syphilis.
It is also possible to get genital ulcers from using bad skin care products. This type of ulcer is characterized by red rashes or bumps that may or may not hurt. It is also possible to have some kind of discharge when you have genital ulcers.
Genital ulcers are often treated with either antibiotic or antiviral pills. For inflamed sores, you might also need to buy a topical ointment to cure it.
The most common type of ulcer, this disease develops in the lining of the stomach and in the upper portion of the small intestine. Peptic ulcer is usually caused by the bacteria Helicobacter pylori, and is characterized by burning pain in the stomach, nausea, and heartburn.
When left untreated, peptic ulcer can lead to internal bleeding, perforation of the stomach lining, and gastric cancer.
Also known as bedsores, this type of ulcer usually occurs when there is prolonged pressure on the skin, which leads to blood flow problems.
People who are forced to sit or lie down for a long period of time are prone to getting bedsores. If untreated, bedsores can lead to skin cancer, bone infections, necrotizing fasciitis (flesh-eating bacteria), or worse, sepsis (infection in the bloodstream).
Most leg ulcers start with an injury that did not heal well because of some serious health issue like heart disease or lymphedema.
Sores can appear on your toes, the bottoms of your feet or the inside of your leg (below the knee). Early signs of leg ulcers include swelling, itching, tingling, redness, dry and scaly skin, and presence of fluid-filled blisters.
Leg ulcers are further subdivided into three types: venous, neurotrophic, and arterial.
Venous ulcers occur when you have a history of blood clots in your legs, experience leg swelling, or have varicose veins. This means the veins in your legs are not adequately circulating the blood to your heart.
On the other hand, both neurotrophic and arterial ulcers occur at the bottom of your feet, heels, or toes. They are usually caused by an underlying medical condition like diabetes.
It is best to consult a doctor if you have leg ulcer because it can lead to amputation if untreated.
What Is Diabetic Foot Ulcer?
Diabetic foot ulcer is one of the most common complications of diabetes. It is characterized by an open wound found at the bottom of the foot.
According to statistics, diabetic patients have a 15 to 25% chance1 of developing foot ulcers, which can further develop into serious infections. For this reason, diabetes is considered the leading cause of lower extremity amputations.
Diabetic foot ulcers can be further classified into three types: ischaemic, neuropathic, and neuroischaemic.
However, unlike the other types of ulcers, those who suffer from diabetic foot ulcer do not feel any pain from their wounds. That’s because foot ulcers damage the nerve as well as the tissue. In some cases, the open wound releases a foul-smelling odor due to tissue and nerve degradation.
As such, it is incredibly important for diabetic foot ulcers to be accurately diagnosed and treated to prevent possible wound infection and amputation. Aside from managing the blood glucose level, doctors often recommend antibiotics and wound care to treat diabetic foot ulcers.
Ozone Therapy as Treatment for Diabetic Foot Ulcers
Clinical studies9 show that developing diabetic foot ulcer contributes to the high mortality and morbidity rates of diabetes around the globe. Because of its complex pathophysiological nature, diabetic foot ulcers are difficult to treat using conventional medicine.
Fortunately, ozone therapy shows a lot of promise in repairing diabetic foot ulcers.
Ozone is an unstable, colorless molecular gas composed of three oxygen atoms that are chemically bonded together. For centuries, medical ozone gas has been used in several medicinal applications because of its therapeutic benefits to biological systems.
Studies also show that medical ozone gas has antibacterial and germicidal2 properties and stimulates fast healing, which can come in handy when addressing open wounds like diabetic foot ulcers.
In a study conducted in China11, patients who were treated with ozone therapy showed a significant reduction in wound size. There was also a notable increase in the production of the essential proteins that are key to rapid wound healing.
Considering the high costs of treating diabetic foot ulcers with conventional methods, ozone therapy seems to be a great alternative for patients suffering from this condition.
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Is It Safe to Use Ozone Therapy as Treatment for Diabetic Foot Ulcers?
Under normal circumstances, ozone therapy is safe without any reported adverse effects. However, more clinical studies must be done to ensure its safety and efficacy in treating diabetic foot ulcers. There are certain nuances in the proper administration of medical ozone gas on the affected area.
There are several ways to administer medical ozone. The most popular way is to intravenously infuse the blood with an ozone-blood mixture. Other methods include insufflation, direct injection, and topical application.
However, each of these methods come with great risk and may do more harm than good if done incorrectly. For example, autohemotherapy might lead to embolism if the ozone concentration that is infused in the blood is not accurate. Consequently, directly injecting medical ozone into the affected tissue or muscle may accidentally result in infection and necrotic wounds.
As such, patients and doctors must take extreme precautionary measures when using ozone therapy to treat diabetic foot ulcers.
It is worthy of note, though, that the insufflation of medical ozone in diabetic rats showed positive results in terms of improving glycemic control and preventing oxidative stress11, both of which are useful for diabetes management.
The same results are reported when the therapy is applied to diabetic rabbits. Aside from glycemic control and inhibited oxidative stress, rectal insufflation also leads to reduced area of lesions and fewer amputations.
Ulcer is one of the most common and most severe complications that can arise from various conditions, including diabetes.
On a healthy person, some types of ulcers resolve on their own. However, having diabetes can complicate ulcers as it can significantly affect the healing process of the wounds.
Diabetics are more likely to develop foot ulcers than any other type of ulcer. Studies show that the probability of acquiring foot ulcer goes as high as 25% for diabetics, with some of the more serious cases resulting in limb amputation.
The neurologic and vascular complications of diabetes, coupled with slow wound healing and opportunistic infections, makes diabetic foot ulcers extremely difficult to treat.
Although it still needs more randomized and controlled clinical trials, ozone therapy presents a great alternative for addressing diabetic foot ulcers. Rectal insufflation showed positive results in reducing wound size, improving wound healing and closure time, and improving the glycemic blood levels of patients.
- Albatanony, A. A., El-Khateep, Y. M., adek, S. A. M. & baghid, A. S. S. (2019). Evaluation of the effect of ozone therapy in diabetic foot ulcers. Menoufia Medical Journal, 32(4), 1272-1276
- Aytacoglu, S. & Aytacoglu, B. N. (2019). Ozone therapy in a patient with diabetic foot ulcerations and a decision for amputation. Case Reports in Clinical Medicine, 8(02), 35-41
- De Leon, A. (2018, June 13). Ozone therapy promotes wound healing in diabetic foot ulcers. Retrieved from http://www.naturalhealthresearch.org/ozone-therapy-promotes-wound-healing-in-diabetic-foot-ulcers/
- Hall, K.-M. (2020, October 1). New portable ozone therapy system helps treat chronic wounds. Retrieved from https://www.verywellhealth.com/portable-ozone-therapy-treat-chronic-wounds-5080013
- Kushmakov, R., Gandhi, J., Seyam, O., Jiang, W., Joshi, G, Smith, N.L. & Khan, S. A. (2018). Ozone therapy for diabetic foot. Medical Gas Research, 8(3), 111-115.
- Menendez-Cepero, S. (2018). Ozone therapy in leg ulcers of patients with chronic venous insufficiency [anstract]. Proceedings of the 5Th WFOT Meeting, 2016 Nov 18, Mumbai, India. Journal of Ozone Therapy, 2(2). doi: 10.7203/jo3t.2.2.2018.11128
- O3 Academy. (n.d.). Ozone for infected wounds. Retrieved from https://o3academy.com/o3-ozone-for-wound-healing/
- Pyper, L. (2016, March 22). Ulcers & ozone therapy. Retrieved from https://salvagente.co.za/ozone-saunas/ulcers-ozone-therapy/
- Wen, Q. & Chen, Q. (2020). An Overview of Ozone therapy for treating foot ulcers in patients with diabetes. The American Journal of the Medical Sciences, 360(2), 112-119. doi: 10.1016/j.amjms.2020.05.012
- Yin, X., Zuo, Z., Liu, H., Xu, Y., tian, X., & Zhou, H. (2017). Optimization of the monochromatic energy in imaging the celiac artery with dual energy spectral CT angiography. Biomedical Research, 28(18), 7841-7845
- Zhang, J., Guan, M., Xie, C., Luo, X., Zhang, Q. & Xue, Y. (2014). Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic patients with foot ulcers. Oxidative Medicine and Cellular Longevity, 2014, Article ID 273475, 8 pages. http://dx.doi.org/10.1155/2014/273475